Association of Socioeconomic Risk Factors of Food Insecurity With Post-abdominal Surgery Complications in the USA

Background Postoperative complications are common for gastrointestinal surgeries, ranging from mild symptoms such as nausea and scarring to fatal outcomes such as hemorrhage and sepsis. Comorbidities and overall preoperative health of a patient impact both surgical outcomes and postoperative complications. Socioeconomic risk factors such as food deserts, healthcare deserts, and transportation limitations can influence the risk of postoperative complications but have limited preexisting data. Proper nutrition has been found to aid in healing and can lessen postoperative complications. Methods We utilized the 2021 National Inpatient Sample from the Healthcare Cost and Utilization Project (HCUP) to analyze the association of food insecurity with common postoperative complications for hernia repair, cholecystectomy, gastric bypass, gastric banding, and enterectomy. Results Multivariate logistic regression adjusting for demographics (age, gender, and race) and comorbidities (diabetes, hypertension, cancer, substance misuse, autoimmune disorders, mental health, chronic obstructive pulmonary disorder (COPD), obesity, vascular disease, and thyroid disorders) showed a 4.5% increase in the risk of postoperative complications in patients at risk of having food insecurity (odds ratio (OR)=1.045; 95% confidence interval (CI): 1.004-1.087; p=0.03). Conclusion This significant increase in risk can be used as a predictor to further refine patient care related to postoperative complications. Providers can use diagnosis codes associated with socioeconomic risk factors in patient charts to flag the patients for additional precautions and follow-up. Additionally, there is a need for more healthcare providers and facilities in areas of food shortage.